In the realm of mental health treatment, understanding the roles of different professionals can be crucial for individuals seeking the proper support. At Madison Avenue TMS & Psychiatry, people often ask, “Do psychiatrists do therapy?”
Although “therapy” can be used to refer to a range of treatments, including medical interventions, most individuals who ask this question want to know if a psychiatrist will provide “talk therapy,” also known as psychotherapy, a primarily conversation-based method of mental health treatment. With that in mind, what kind of therapy can you expect from a psychiatrist?
Do Psychiatrists Do Talk Therapy?
Yes, psychiatrists do provide talk therapy, but it’s important to distinguish their role from that of other mental health professionals. Psychiatrists are medical doctors who specialize in the diagnosis, treatment, and prevention of mental illnesses. While they are trained in various forms of therapy, such as psychotherapy or counseling, their primary focus is often on prescribing medication and managing the biological aspects of mental health conditions.
Psychiatrists also do therapy sessions with their patients, especially when medication management is part of the treatment plan. These sessions typically involve discussing medication’s effects, monitoring progress, and addressing any concerns or side effects. However, for more in-depth, regular talk therapy, individuals often seek the expertise of psychologists, counselors, or therapists who specialize in various therapeutic approaches.
The Roles Of Different Mental Health Professionals
The mental health field is diverse, with a range of professionals available to meet the needs of the public.
Psychologists are trained professionals who study and treat mental processes and behaviors, utilizing various therapeutic approaches. A distinct profession from psychiatrists, they are not medical doctors and cannot prescribe medication.
Psychiatric physician associates are healthcare professionals trained to work alongside psychiatrists, assisting in patient care and treatment planning. Their role is supplemental, so they will not usually lead a therapy session or prescribe medication.
Therapists can refer to a range of mental health professionals who employ various therapeutic techniques to assist clients in understanding and overcoming psychological difficulties. They are not medical doctors and cannot diagnose conditions or prescribe medications.
Counselors are non-medical professionals trained to guide and support individuals or groups, helping them navigate emotional and mental health challenges.
Social workers are non-medical professionals who help individuals and communities cope with various life challenges by providing support, resources, and advocacy for mental and emotional well-being. LCSW (licensed clinical social workers) can provide therapy.
Choosing the right mental health service for you can depend on various factors, including the severity of your symptoms, availability of services in your area, past treatment history, and insurance coverage.
What Treatments Can You Get From A Psychiatrist?
Talk therapy can be a powerful tool, but it often isn’t enough to address the biological basis of many mental health disorders like depression, which stem from chemical irregularities in areas of the brain, such as the prefrontal cortex. Often, some form of medical intervention is required, whether as a standalone treatment or supported by psychotherapy, and that’s where psychiatrists come in (1,2).
While pharmaceuticals such as antidepressant medications are usually the first-line treatment options, at Madison Avenue TMS & Psychiatry, we recognize the evolving landscape of mental health care and offer innovative treatments like Transcranial Magnetic Stimulation (TMS). TMS is a non-invasive and FDA-approved therapy for individuals with treatment-resistant depression or obsessive-compulsive disorder (OCD). It uses tiny magnetic pulses to stimulate specific brain areas associated with the symptoms of mood disorders to regulate neurotransmitter activity to a healthy level.
TMS is an effective alternative for individuals with depression, obsessive-compulsive disorder (OCD), anxiety, or post-traumatic stress disorder (PTSD) who may not respond well to traditional forms of psychotherapy or medication alone (3, 4, 5, 6). Unlike pharmaceutical interventions, TMS has minimal side effects and does not involve systemic exposure to drugs. At Madison Avenue TMS & Psychiatry, we work closely with patients to determine if TMS is a suitable option, providing personalized care to address the unique needs of each individual.
Do I Need A Psychiatrist?
Psychiatrists play a crucial role in addressing the biological aspects of mental illnesses, including medication management. While they do engage in therapy sessions, their primary focus is often on the medical aspects of treatment. For those seeking comprehensive mental health care, it’s essential to consider a personalized approach with the assistance of a medical doctor, such as a psychiatrist, to find the best treatment.
If you or a loved one is navigating the complexities of mental health treatment, Madison Avenue TMS & Psychiatry is here to help. Our experienced team of psychiatrists, psychiatric nurse practitioners, and psychiatric physician associates offers various services, including talk therapy, medication management, and innovative treatments like TMS.
Take the first step toward mental well-being by contacting us online or calling (212) 731-2033 for an appointment or consultation. Let us be your partner on the journey to improved mental health!
Resources:
van Bronswijk S, Moopen N, Beijers L, Ruhe HG, Peeters F. Effectiveness of psychotherapy for treatment-resistant depression: a meta-analysis and meta-regression. Psychological Medicine. 2019;49(3):366-379. Link. Accessed January 11, 2024.
Jobst A, Brakemeier E-L, Buchheim A, et al. European Psychiatric Association Guidance on psychotherapy in chronic depression across Europe. European Psychiatry. 2016;33(1):18-36. Link. Accessed January 11, 2024.
Sackeim HA, et al. Clinical Outcomes in a Large Registry of Patients with Major Depressive Disorder Treated with Transcranial Magnetic Stimulation. J Affective Disorders. 2020; 277(12):65-74. Link. Accessed January 11, 2024.
Roth Y, Barnea-Ygael N, Carmi L, Storch EA, Tendler A, and Zangen A. Deep transcranial magnetic stimulation for obsessive-compulsive disorder is efficacious even in patients who failed multiple medications and CBT. Psychiatry Research. 2020;290:113179. Link. Accessed January 11, 2024.
White D, Tavakoli S. Repetitive transcranial magnetic stimulation for treatment of major depressive disorder with comorbid generalized anxiety disorder. Ann Clin Psychiatry. 2015 Aug;27(3):192-6. Link. Accessed January 11, 2024.
Petrosino, N. J., Cosmo, C., Berlow, Y. A., Zandvakili, A., & Philip, N. S. Transcranial magnetic stimulation for post-traumatic stress disorder. Therapeutic Advances in Psychopharmacology, 2021;11. Link. Accessed January 11, 2024.
‘Tis the season: With autumn well under way, the days are growing shorter — and once daylight saving time goes into effect, it may be dark outside when you wake up, leave work or both. That can make sunshine feel like a precious but scarce resource.
That lack of daylight can have a profound effect on many people, giving rise to a condition known as seasonal affective disorder, or SAD. It’s typically associated with the shorter daylight experienced in the late fall and winter months, though there’s a much less common form of the condition known as summer-pattern SAD, or summer depression.
Although it’s seasonal in the sense that symptoms usually clear up with the return of more daylight in the spring, SAD is considered a form of depression, with the ability to affect your behavior, feelings and thinking. As such, you’re at increased risk of having SAD if you have a major depressive or bipolar disorder, or have blood relatives who do.
Other risk factors include living in cloudy locales or in far-northern or far-southern latitudes that receive significantly less sunlight in winter.
Symptoms of SAD
Seasonal affective disorder can mirror other types of depression in its signs and symptoms:
Feeling sad, listless or down
Feeling hopeless or worthless
Low energy and sluggishness
Loss of interest in things you usually enjoy
Sleeping too much
Overeating, craving carbohydrates and gaining weight
Difficulty focusing
The primary difference from other forms of depression is its pattern of occurring during specific seasons.
What Causes SAD?
While the causes of SAD are not entirely understood, researchers have focused on the role of serotonin, a neurotransmitter chemical in the brain that helps regulate mood. It’s believed that shorter daylight hours interfere with certain molecules that help maintain serotonin, leading to lower levels during the fall and winter.
Another contributing factor may be a deficiency of vitamin D, an important nutrient that influences serotonin production. While vitamin D can be derived from certain fatty foods and nutritional supplements, the biggest source is through exposure of the skin to sunlight, making it harder to generate during winter in northern climates like New York.
There’s also your internal biological clock, which regulates your mood, sleep and hormones, and which shifts when daylight decreases, putting you out of sync with the routines and schedules you’re accustomed to.
Lastly, research suggests a link between SAD and over-production of melatonin, a hormone that regulates sleep, making those who suffer from the disorder prone to fatigue and oversleeping.
How Do You Treat SAD?
First off, rather than trying to diagnose yourself, you should see your doctor for help determining whether you have seasonal affective disorder or something more serious. Your doctor may refer you to a psychologist or psychiatrist, who can ask questions about your symptoms, their pattern and whether you have a family history of any mood disorders, among other things.
Once diagnosed, there are several ways to treat SAD, some of which may be combined.
Cognitive behavioral therapy. This form of talk therapy can help you learn ways to manage stress and cope with SAD, including by planning meaningful activities and incorporating healthy habits such as exercise, eating nutritious food and following good sleep patterns. Psychotherapy can also help you identify negative thoughts that may be making you feel worse so you can change them.
Light therapy. This can range from opening the blinds at home to let in more sunlight to sitting closer to bright windows whenever indoors to purchasing a light box that uses white light to mimic sunlight. Light boxes are brighter than indoor light and have a screen to filter ultraviolet rays. They’ve been found to be effective in regulating mood and energy levels when used properly, for 15 to 30 minutes each day.
Antidepressants. Your psychiatrist may prescribe a serotonin uptake inhibitor to manage your depression symptoms, possibly in combination with light therapy.
Vitamin D supplements. Your therapist may recommend a supplement to help manage your symptoms.
Spending more time outside. In addition to offering a break from cabin fever and providing a welcome change of scenery, getting outside exposes you to more sunlight. That said, studies suggest that it takes much longer for the body to produce sufficient vitamin D from winter sunlight in northern latitudes than in brighter, southern locales.
Get Help Treating SAD in NYC
If you’re noticing a downturn in your mood and overall outlook when the daylight diminishes, Madison Avenue TMS & Psychiatry can help. Our office in Manhattan is staffed by caring experts who listen and can tailor a treatment plan to your unique needs.
To learn more or schedule a consultation with our team, call us at (212) 731-2033.
Public awareness of depression as a serious mental health issue has increased over time, a trend that has helped more people seek help from medical professionals. While current figures are hard to come by, federal data suggest that just over 13% of adults in the U.S. used antidepressants from 2015-2018, and there is evidence that usage since then is increasing, particularly among young people.
When they work as intended, antidepressants help patients improve their mood and outlook, rediscover motivation for daily tasks and hobbies, and experience fewer symptoms. Typically, antidepressants succeed at reducing symptoms for between 40% and 60% of patients. Yet a recent study in the U.K. found that nearly 75% of respondents self-reported that selective serotonin reuptake inhibitors (SSRIs) made them feel better, against just 18.8% who said they were not helpful.
And yet, some people who use them report that antidepressants make their depression worse.
While there is scant evidence to support that claim outright, antidepressants are like any other medication in that they bring side effects and produce different results for different people. Physicians prescribe them only after carefully weighing the patient’s mental health needs against many other factors, and they often make adjustments or changes based on whether they are proving effective at alleviating symptoms.
Why Antidepressants Sometimes Fail
The truth is that antidepressants can make you feel worse at first due to side effects that usually improve over time such as:
Weight gain or loss, due to changes in appetite
Sexual side effects, including loss of libido
Fatigue
Insomnia
Antidepressants are also known to sometimes make anxiety spike, possibly because serotonin activates the release of a hormone associated with the body’s “fight or flight” response, even when there is no threat. This, too, is usually a temporary side effect.
There are other possible problems that may make patients feel like their antidepressants are making things worse:
Alcohol use. Drinking can interfere with the medication and its benefits, worsening depression and anxiety.
The dose is too low. If the dosage of your antidepressant is too low, you may experience no relief from depressive symptoms or feelings of hopelessness, with no improvement even after months on the drug.
The dose is too high. If your dose is too strong, you may experience symptoms such as excessive fatigue, GI issues, changes in heart rate, or feeling numb or detached.
Wrong type of antidepressant. A lack of improvement after sustained usage may also indicate a need to try a different medication — or even a different class of antidepressant, such as a serotonin-norepinephrine reuptake inhibitor, or SNRI.
In addition, sometimes antidepressants don’t work, or stop working, a condition known as antidepressant tolerance. When patients see no improvement after a sufficient regimen of antidepressants and psychotherapy, it’s called treatment-resistant depression (TRD) — a condition we specialize in here at Madison Avenue TMS and Psychiatry and which we outlined in a previous blog.
What to Do If Antidepressants Aren’t Working
It’s important to remember that it can take weeks or months for antidepressants to take effect and that every person’s experience using them differs. So giving them adequate time before rendering judgement about whether they are working is important.
If your antidepressants aren’t working, talk with your doctor or psychiatrist about what’s happening to find the best course of action. It could be as simple as adjusting your dosage, or it may involve trying a new medication to see if it works better for you.
Or, if you have TRD, you may be a good candidate for transcranial magnetic stimulation (TMS) or Spravato, an FDA-approved nasal spray, both of which we provide here in our Manhattan office. Call us at 212-731-2033 to learn more about available options.
Take the following testimonial from Monica Densmore, a real patient at Madison Avenue TMS & Psychiatry. We’re giving her a pseudonym to honor her wish to remain anonymous.
Prior to trying TMS, she had tried years of cognitive behavioral therapy and several antidepressants, to no avail.
“Before receiving TMS, I hadn’t felt happiness, as an actual emotion, since childhood – maybe first or second grade,” she said. “The first time I completed TMS, I was 22 years old and in my final semester of college. Happiness felt totally foreign to me, like visiting a country that I had forgotten existed.”
Monica knows that depression can be an excruciating experience, but she wants people to know that “every single person deserves the chance to get better.”
As a reminder, if you or someone you know is having thoughts of suicide, help is available by dialing 988, the 24-hour suicide hotline, or contacting a local crisis help line in your area.
Paralyzed By Despair
Monica Densmore had struggled with major depression since she was a young girl. Despite years of cognitive behavioral therapy and being prescribed antidepressants, nothing worked.
Her depression seemed permanent and unshakable.
“For me, depression manifested as constant background despair. I was only able to feel sad or anxious, which made it very difficult for me to connect with the people around me,” she said. “While I did have friends, I rarely felt motivated to reach out to them; when I wasn’t at work or school, I was in bed, staring at a wall and self-isolating.”
Densmore struggled with insomnia and thoughts of suicide, and she found it difficult to think clearly and complete even basic tasks.
“Depression created friction in every part of my life,” she said. “I felt like I had to drag myself through each day like a reluctant animal on a leash.”
Discovering the Power of TMS
Densmore tried transcranial magnetic stimulation, or TMS, for the first time in 2012, when she was a college student. She was willing to try anything in pursuit of getting better, yet she secretly feared that, like all the years of talk therapy and medications before, TMS wouldn’t work.
Yet it did. The TMS protocol sent Densmore’s treatment-resistant depression into remission, and the results amazed her.
“The relief I felt was indescribably intense,” Densmore said. “Without exaggeration, it saved my life.”
Since then, she has returned for annual TMS treatment when she feels herself relapsing into depression.
Densmore, who teaches creative writing and literature at a local college, acknowledges that it can be challenging to fit her regimen of 36 daily TMS appointments into her busy schedule, but sees it as a non-negotiable: “I make arrangements and find the time, because I want to be alive, I want to be happy,” she said. “I don’t want to drag myself miserably through life when this miraculous alternative exists.”
If her depression begins to relapse, Densmore said she notices a positive shift toward remission two to three weeks into the TMS regimen.
“Going into remission feels like turning on all the lights again in a dark room,” she said. “My insomnia begins to abate, letting me sleep through the night again, and my mind clears, anxiety giving way to calm clarity.
“In general, my life just becomes easier. I call my friends, I go to work, I make art, I walk through the park – all of this without depression’s typical dread or drag attached. And, maybe more than anything else, I can experience genuine happiness.”
Help Getting Her Life Back on Track
Densmore has been receiving her TMS therapy from Madison Avenue TMS & Psychiatry for several years now, following a move to New York City and a change in her insurance coverage. She complimented the staff for its courtesy, warmth and responsiveness.
“So much of my experience in navigating mental health resources is fighting with insurance companies, but Madison Avenue TMS takes care of everything,” she said. “I’ve never had such a seamless experience. The staff takes on so much of the burden and clears the path to getting the care that I need.”
Densmore credits TMS for improving many things: her friendships, her relationships with her family, her career, creativity, education, sleep, and overall outlook.
“So much of what depression made feel impossible is now easy,” she said. “I can call and see friends, keep in touch with family. Even when my life gets stressful or chaotic, I can think clearly, make plans, and maintain a sense of hope while focusing on the future. I’m much more extroverted, proud of the work I produce, and just sharper in general.
“Even though I’ve treated my depression with TMS for over a decade now, this ease still feels surreal sometimes. I can’t believe, or even really fully describe, how much better things are now.”
Make an Appointment With Madison Avenue TMS & Psychiatry
For those struggling with depression or mental health, our team is here to help and support you. We want you to know – relief is possible. Call us at 212-731-2033 or visit our ‘contact’ page at madisonavetms.com to schedule an appointment.
SPRAVATO Treatment in NYC: A New Hope for Adults with Treatment-Resistant Depression
Still feeling stuck after trying multiple depression treatments?
You’re not alone, and you may not need more of the same. At Madison Avenue TMS & Psychiatry, we proudly offer FDA-approved SPRAVATO (esketamine) nasal spray, a breakthrough therapy for adults with treatment-resistant depression (TRD) or major depressive disorder (MDD).
As a Risk Evaluation and Mitigation Strategy (REMS)-certified SPRAVATO treatment center in NYC, we provide compassionate outpatient care, evidence-based plans, and experienced clinicians in a comfortable, centrally located Manhattan office.
We accept a wide range of insurance plans. Don’t see yours listed? Contact us to confirm coverage.
What Is SPRAVATO?
SPRAVATO is a nasal spray formulation of esketamine, approved by the FDA for use in adults with treatment-resistant depression and depressive symptoms in MDD with suicidal thoughts or behaviors. It works differently from traditional antidepressants.
SPRAVATO is believed to act as an NMDA receptor antagonist, which affects glutamate, a neurotransmitter associated with mood and cognition.
Unlike standard antidepressants that may take 4–6 weeks to show effects, some patients report improvement within 24 hours of their first dose.
What to Expect from SPRAVATO Treatment at Madison Avenue TMS in New York
Pre-Treatment Consultation
Our psychiatric team will review your medical history, discuss your symptoms, and determine whether SPRAVATO treatment for depression is right for you. We’ll handle insurance verification and walk you through the treatment process.
In-Clinic Treatment Sessions
SPRAVATO is administered via nasal spray under the direct observation of licensed clinicians in a comfortable, private suite. You’ll be monitored for at least two hours after treatment to ensure your safety and comfort. Patients must arrange transportation; while they cannot drive themselves, they may use public transit, rideshares, or walk.
Treatment Schedule
Weeks 1–4: 2 sessions per week
Weeks 5–8: 1 session per week
Week 9 and beyond: Maintenance varies; some patients taper to every other week
You don’t have to navigate this journey alone, whether you were referred by a provider or found us on your own, our team is here to support you every step of the way and will check in regularly to ensure your care stays on track.
Why Choose Madison Avenue TMS for SPRAVATO Treatment?
We’re not a wellness chain or trendy clinic. Madison Avenue TMS offers trusted psychiatric care and specialized dual-modality treatments in one place:
Board-certified psychiatrists with over a decade of experience Access to both SPRAVATO and TMS therapy, customized to your needs Evidence-based care in a discreet, central NYC location Transparent insurance and billing support, including patient assistance programs Collaborative treatment plans that prioritize your long-term healing Specialization in combining TMS + ketamine-based treatments for improved outcomes Clear communication from the first call to the final session
Affordability Support for Patients
Commercially insured patients have 2 ways to save
Patients pay as little as $10 per treatment for SPRAVATO medication
SPRAVATO withMe Savings Program
Treatment may include up to three devices administered on the same day. There are quantity limits and a maximum program benefit per calendar year. Offer subject to change or end without notice. Program does not cover the cost of treatment observation. Patients can participate without sharing their income information.
Patients pay as little as $10 after rebate for observation of each treatment
SPRAVATO withMe Observation Rebate Program
There is a limit to savings each year. Offer subject to change or end without notice. Not valid for residents of MA, MI, MN, or RI. Patients may participate without sharing their income information.
SPRAVATO withMe can provide information about other resources that may be able to help your patients with out-of-pocket medication costs, such as:
State Health Insurance Assistance Programs (SHIPs)
State Pharmaceutical Assistance Programs (SPAPs)
Medicare Savings Program
Medicare Part D Extra Help
To learn more about eligibility and how these programs may help your patients pay for Medicare Part D products, visit medicare.gov/your-medicare-costs.
SPRAVATO is an FDA-approved esketamine nasal spray for adults with TRD or MDD with suicidal thoughts. It must be administered in a REMS-certified clinic under medical supervision.
Unlike IV infusions, SPRAVATO is a nasal spray formulation approved by the FDA, taken with or without oral antidepressants, and administered in a monitored setting. It is covered by most insurance plans.
We welcome partnerships with psychiatrists, primary care physicians, and therapists. Our REMS-certified clinic has experience with complex TRD cases and collaborates closely with referring providers. We offer timely updates and prioritize continuity of care.
SPRAVATO treatment at our NYC clinic could be the breakthrough you’ve been looking for.
Fast-Acting
Insurance-Friendly
Compassionate Care
Call (212) 731-2033 or complete the form below to request your free consultation today.
SPRAVATO carries a risk for sedation, dissociation, and misuse. Patients are monitored for at least two hours after treatment. Learn more in the full Prescribing Information and Medication Guide for more details.
If you’re living with depression, you may feel ashamed and maybe even hopeless. At Madison Avenue TMS & Psychiatry, we want you to know that you are not alone, and there is hope.
Even if you feel like you’ve tried everything, we are here to listen to your story, to meet you where you’re at, and be by your side as you take the brave step of pursuing new options.
Every member of our care team brings compassion, rich experience and professional expertise to help patients find their way back to a brighter, more fulfilling life.
Below, we invite you to get to know the people who are here to support you on your healing journey.
Meet our team
Dr. David Woo Founder & Clinical Psychiatrist
Dr. David Woo is the founder and lead psychiatrist at Madison Avenue TMS & Psychiatry in Midtown Manhattan. Board-certified in psychiatry and geriatric psychiatry, he has spent his career helping patients find relief from depression, anxiety, OCD, and other mental health conditions. By offering TMS therapy at his practice, his goal is to offer new hope to patients whose mental health hasn’t improved with medication or psychotherapy. Through tailored, compassionate and evidence-based care, he has helped hundreds of New Yorkers take steps toward healing.
Olivia Tween
Clinical TMS Coordinator & Technician
Olivia acts as our primary liaison between patients, providers, technicians, and insurance companies, managing care teams, helping to resolve issues with billing, and coordinating referrals. In addition, she administers TMS treatments, performs mental status examinations, and assesses treatment progress.
Prior to joining Madison Avenue TMS & Psychiatry, Olivia worked as a residential counselor at Silver Hill Hospital, where she supported people through a four-week residential program focused on Dialectical Behavioral Therapy (DBT).
“In both roles, I’ve had the privilege of watching patients gradually transform into healthier, more vibrant, and hopeful versions of themselves,” says Olivia. “It is a privilege to guide people through something that can at first feel frightening and uncertain. Doing so alongside a team of technicians who bring skill, compassion, and genuine encouragement to every interaction has been deeply rewarding.
“I am so proud to be part of a practice that puts patient care first and believes in each person’s capacity for change.”
Lana Baroni
TMS Technician
Lana is experienced in both TMS therapy and clinical psychology, completing psychoanalytic training both here in the United States and in Brazil.
“One of my favorite aspects of working as a TMS technician is the opportunity to connect with patients on a personal level, hearing their histories and learning about their trajectories,” says Lana. “It’s rewarding to witness their progress throughout the treatment, often within just a few weeks, and to see the positive changes that TMS can bring to their lives.”
Molly Gilligan
TMS Coordinator & Technician
Molly has been with Madison Avenue TMS & Psychiatry for over two years.
“I feel grateful to be part of the team at Madison Ave TMS & Psychiatry,” says Molly. “It’s a meaningful experience to support patients throughout their treatment, listen to their stories, and build genuine connections along the way. Dr. Woo and my colleagues create a welcoming and supportive environment for everyone who comes through our practice.”
Molly is also currently pursuing a master’s degree in clinical social work. “I feel lucky to be at a workplace that continuously encourages and inspires my growth in the mental health field.”
Outside of work, Molly enjoys creating art, cooking, and spending time outdoors with her dog and friends.
Maria Mount
TMS Technician
Maria has a background in psychiatry, in both clinical and research settings. She has been with us for over a year and during her time here, has led over 1,200 TMS sessions.
“Working directly with so many different patients is one of the most meaningful parts of my position,” says Maria. “I enjoy building rapport and strive to be a helpful part of their TMS treatment. I am also grateful to work with such a dedicated and compassionate team at Madison Ave TMS & Psychiatry!”
Outside of work, Maria enjoys travelling, reading, and exploring NYC — especially trying new restaurants and going to Broadway shows.
Photo not available
Jessica Sokolovsky
Administrative Specialist
Jessica describes herself as a dedicated healthcare professional with a passion for delivering compassionate and high-quality care. With experience in managing insurance verification, claims resolution, and prior authorizations, she ensures patients receive seamless, efficient care.
“I am committed to providing every patient with a supportive and empathetic experience, ensuring they feel heard and valued,” says Jessica. “My goal is to create a positive environment… while continuing to grow professionally and make a meaningful impact on patient care.”
In her free time, Jessica enjoys reading, working on puzzles, playing video games and spending time with family and friends.
Michael Efremov-Kendall
Practice Administrator & TMS Technician
Michael has supported patients at Madison Avenue TMS & Psychiatry for four years, serving as both a Practice Administrator and a certified TMS Technician.
“Working with patients through their TMS treatment course has been rewarding over the years because I get to help destigmatize many of the stereotypes associated with mental health,” he says. “I have learned that no two cases are the same.”
Outside of the office, Michael enjoys camping, cooking, and comedy.
What patients are saying
Below are just some of the testimonials we receive from our patients. Out of respect for their privacy, we are keeping them anonymous.
“Dr. Woo and team are highly professional and caring. They seem genuinely interested in alleviating your symptoms and helping you on your journey to feel better.”
“I came in with severe depression. Dr Woo and his staff were very accommodating and explained the process very clearly. They were very knowledgeable and thorough. They made me feel comfortable and informed. I finished the treatments and felt my depression had significantly improved. I highly recommend Madison Avenue TMS & Psychiatry.”
“I can’t recommend Dr. Woo and his clinical staff enough. I had a lot of questions, and they were extremely helpful and responsive. Their responsiveness and flexibility made getting my regular TMS treatments much easier than they could have been.”
“Dr. Woo and his outstanding staff were amazing, encouraging and supportive through a sometimes difficult treatment protocol.”
“My depression has lessened and I do think the treatment and the personal care of the team were beneficial. Thank you. You are a blessing.”
We’re here for you. Schedule a consultation today.
If you are struggling with depression or haven’t found relief from other treatments, you don’t have to face it alone. Our expert and compassionate team at Madison Avenue TMS & Psychiatry is here to support you every step of the way.
We invite you to schedule a consultation with our care team today to learn how we can help you embark on a path toward better mental health. Contact us on our website or call us at (212) 731-2033.
If you’ve been living with treatment-resistant depression, you know the struggle. Medications don’t work. Talk therapy doesn’t work. It can feel like nothing will ever work.
At Madison Avenue TMS & Psychiatry, we help patients find relief from depression. One treatment option we consistently see provide life-changing results is TMS (transcranial magnetic stimulation). And through personalized treatment plans, we offer the most advanced TMS protocols available.
Read on to learn more about TMS and which protocol might be right for you.
What Is TMS?
“TMS therapy is an FDA-approved, non-invasive form of brain stimulation that uses painless magnetic pulses to stimulate specific areas of the brain,” says Dr. David Woo, head clinical psychiatrist and founder of Madison Avenue TMS & Psychiatry. “As a treatment for depression, it has proven its effectiveness through numerous clinical trials. Treatment usually involves daily 20-minute sessions over several weeks.”
TMS has also shown promise in treating conditions like anxiety, bipolar disorder, postpartum depression and epilepsy. Unlike electroconvulsive therapy (ECT), TMS doesn’t require anesthesia or cause memory loss. You stay fully awake during each outpatient TMS session.
How TMS Works
Depression can silence parts of the brain, especially the left dorsolateral prefrontal cortex (DLPFC), the area responsible for joy, energy, focus, and motivation. Low activity in this region often leads to depressive symptoms like fatigue, hopelessness, and emotional numbness.
TMS uses a specialized TMS coil to deliver a magnetic field that reactivates underperforming neurons in specific areas of the brain. Over time, repeated TMS sessions (rTMS) can rebuild healthier brain connections and improve mood and overall outlook.
Targeting Specific Brain Regions with Custom TMS Coils
“Research has shown that certain mental health conditions are particularly responsive when treatment targets specific brain regions. And we target these brain regions by using different TMS coils housed in the TMS helmet,” says Dr. Woo.
“These coils differ in width, depth, and magnetic frequencies to correspond to the unique makeup of specific brain regions. For example, for Obsessive-Compulsive Disorder (OCD), we use Brainsway’s H7 coil, which targets deeper areas of the brain’s right hemisphere. For depression, we use the H1 coil to target the brain’s left hemisphere.”
Types of TMS Protocols
A TMS protocol is the combination of frequency levels (pulses per second) and how often they are administered. At Madison Avenue TMS & Psychiatry, we tailor your TMS treatment plan to include specific protocols to match your needs, symptoms, and goals. After a thorough evaluation, your care team will determine which TMS protocol is right for you to ensure your treatment is as effective and personalized as possible.
High-Frequency TMS
Our most widely used protocol, high-frequency TMS, delivers 18Hz stimulation (18 magnetic pulses per second) to the left cortex. “This approach is ideal for individuals with major depressive disorder who haven’t found relief through antidepressant medications,” says Dr. Woo. “It helps jumpstart brain activity and restore healthy connectivity across your emotional processing centers.”
Bilateral TMS
If you’re one of the many people who live with both depression and anxiety, this protocol may be for you. Bilateral TMS applies high-frequency pulses to the left cortex and low-frequency stimulation to the right cortex to rebalance overactive and underactive areas. It addresses the imbalance of brain activity that can make emotional symptoms feel overwhelming.
Theta Burst TMS (iTBS)
One of the major breakthroughs with TMS has been the discovery of Intermittent Theta Burst Stimulation (iTBS). “When pulses are delivered with multiple specific high frequencies, they can trigger certain brain waves, called theta waves, which are associated with learning,” says Dr. Woo. “By matching up theta waves with high frequencies (5 Hz and 50 Hz), we have a powerful way of producing change in brain regions.”
iTBS is FDA-approved and clinically proven to produce high remission rates with minimal side effects. “We see these results and prescribe iTBS regularly in our clinic, both on its own and as part of our accelerated TMS options,” says Dr. Woo.
Accelerated TMS
Accelerated TMS is an intense, fast-tracked form of TMS treatment not yet covered by insurance. However, first introduced through the Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT protocol) study, it serves as an example of how accelerated and innovative treatment protocols can dramatically reduce depressive symptoms. For example, 90% of the study’s participants with treatment-resistant depression achieved remission within just five days.
The SAINT protocol involves 5-10 daily sessions, spaced roughly 50 minutes apart, over five consecutive days. It also uses advanced imaging (fMRI) to identify the precise brain region to target with intermittent theta-burst stimulation (iTBS).
“Though insurance doesn’t yet cover the SAINT protocol, our practice offers an accessible alternative by combining standard TMS with theta burst sessions,” says Dr. Woo.
Why Choose TMS
If you’ve tried antidepressant medication and talk therapy with little success, TMS may be the solution you’ve been searching for.
With TMS, patients have:
No serious side effects
No memory loss
No downtime or hospital stays
TMS is FDA-approved for All Age Groups
Brainsway TMS technology has FDA clearance to treat depression in young, middle-aged and older adults (ages 68–86). Some major healthcare providers even cover TMS treatment for adolescents in specific cases.
We offer thorough evaluations to determine your eligibility and ensure your care is safe, appropriate, and effective at any age.
Take the FIrst Step to Starting Your TMS Treatment
If you’ve been feeling hopeless or stuck, we want you to know there are options. Our team is here to guide you step by step through your TMS journey, from the first consultation to insurance coordination, to every follow-up.
Contact us to schedule an appointment or to learn more about TMS therapy in New York City.
“TMS therapy is an FDA-approved, non-invasive treatment option that uses painless magnetic fields to stimulate nerve cells in the brain,” says Dr. David Woo, head clinical psychiatrist and founder of Madison Avenue TMS & Psychiatry
Often prescribed for patients looking for drug-free alternatives, or when antidepressant medications haven’t worked, TMS can feel like a welcome change — especially because it causes no side effects.
In 2020, one of the largest TMS studies to date found that over 70% of patients showed a significant reduction in their treatment-resistant depression symptoms.
For millions of people living with major depressive disorder (MDD) and treatment-resistant depression (TRD), this was and is a big deal. The study adds to a growing body of research that shows Transcranial Magnetic Stimulation (TMS) is not only effective for treatment-resistant depression but also for other mental health conditions such as anxiety, obsessive-compulsive disorder (OCD), and postpartum depression.
For those who have tried medication after medication with little to no relief, findings like these offer something incredibly important: hope. We see the results every day at our practice in NYC — TMS works.
Read on to see more evidence-based examples of how TMS is a game-changer for mental health.
TMS Can Augment Psychotherapy and Improve Medication Efficacy
While TMS can be used as an effective treatment in and of itself, it has also been found to enhance the effectiveness of other treatments.
For example, one study explored the combined use of TMS and psychotherapy, particularly for patients diagnosed with post-traumatic stress disorder (PTSD). The findings demonstrated that pairing TMS with trauma-focused therapy better reduced symptoms than using either approach alone.
Another study suggests that TMS can make the brain more receptive to medication like SSRIs (selective serotonin reuptake inhibitors), such as Zoloft or Prozac.
A common theme associated with TMS research is neuroplasticity, or the brain’s ability to change. Researchers believe that TMS enhances the brain’s neuroplasticity, resulting in improved and lasting outcomes.
“When we think about mental health treatment, we’re often looking for ways to break through barriers in the brain’s response to care. TMS helps us do that,” says Dr. Woo.
TMS Accelerates Symptom Relief
The SAINT Protocol
The SAINT protocol (Stanford Accelerated Intelligent Neuromodulation Therapy) involves 10 TMS sessions per day, spaced roughly 50 minutes apart, over five consecutive days. It also uses advanced imaging (fMRI) to identify the precise brain region to target with intermittent theta-burst stimulation (iTBS). This high-intensity approach dramatically shortens the treatment timeline compared to standard TMS, which typically involves one session per day over 4–6 weeks
In Stanford’s 2020 study, 90% of participants with treatment-resistant depression achieved remission within just five days.
While the results of this study are remarkable, the SAINT protocol is not widely offered yet and is not covered by insurance, making it unviable for most patients. The intensive scheduling demands of the treatment also add complications.
However, there are other forms of accelerated TMS, including Deep TMS, that are widely available and covered by insurance.
Deep TMS
Deep TMS (dTMS) is a form of the treatment that targets deeper and broader regions of the brain using a specially designed helmet-shaped coil. Sessions can include one or more per day, depending on individual treatment plans.
In June 2025, the global medical technology company Brainsway released results from a study it conducted on Deep TMS. They showed that participants who underwent Deep TMS had shorter treatment sessions yet reached symptom remission faster than participants who underwent standard TMS.
The study reported that more than 80% of participants responded to treatment, and over half achieved remission.
Accessible, Accelerated TMS Treatment in NYC
“At Madison Avenue TMS & Psychiatry, we offer alternatives to the SAINT protocol, including Deep TMS, that deliver life-changing results and are covered by most insurance and Medicaid,” says Dr. Woo.
These protocols are grounded in the same scientific principles that make SAINT so effective, but provide the accessibility and flexibility that everyday patients need.
“We tailor TMS treatment plans by adjusting the number of theta bursts the patient receives during their appointment,” says Dr. Woo. “As we check in with them week to week, we can continue to refine their treatment plan to meet their needs.”
You’re Not Out of Options
If you’re struggling with depression that hasn’t improved with medication or therapy, know that you’re not out of options. TMS offers a research-backed, medication-free approach that could help you feel better, possibly sooner than you thought possible.
Contact us to schedule a consultation and find out if TMS is the right fit for you.
A step-by-step guide for patients beginning Spravato treatment for treatment-resistant depression (TRD)
If you’ve been struggling with depression that hasn’t improved with traditional antidepressants or therapy, you’re not alone. Treatment-resistant depression is real, and according to recent research, about one-third of patients with major depressive disorder (MDD) did not respond to two or more oral antidepressants.
If you can relate, you may be a candidate for a treatment that’s helping people find relief when other options haven’t worked: Spravato (esketamine).
Spravato is an FDA-approved nasal spray for adults with treatment-resistant depression or MDD with suicidal thoughts or behaviors. Self-administered under the supervision of a mental health or healthcare professional, it works differently from traditional antidepressants by targeting glutamate, a neurotransmitter associated with mood regulation.
As a certified Spravato treatment center, our team at Madison Avenue TMS & Psychiatry created this step-by-step guide to help you know what to expect at your first Spravato appointment and beyond, to help you feel more confident and at ease.
Before Your First Spravato Appointment
Do I need an initial evaluation to be eligible for Spravato? Yes, before being prescribed Spravato, it is important to complete a comprehensive psychiatric evaluation. Your mental health provider will review your mental health history, current symptoms, previous medications, and overall medical history to determine whether you’re a candidate for the medication.
“We always take time to understand a patient’s full journey,” says Dr. David Woo, head clinical psychiatrist and founder of Madison Avenue TMS & Psychiatry. “This helps us understand what treatment options the patient is open to and allows us to craft a tailored treatment plan to meet their needs.”
Is Spravato covered by insurance? Spravato is typically covered by most commercial insurance plans and Medicare Advantage, but it does require pre-authorization.
“Our administrative team will work with your insurance provider to confirm coverage, submit paperwork, and ensure eligibility before your first dose,” says Dr. Woo. “We also help patients enroll in financial assistance programs like the Spravato WithMe Support Program, if applicable.”
Do I need to prepare for my first Spravato treatment session? You’ll need to arrange transportation for the day of your appointment, as patients are not allowed to drive or operate heavy machinery after treatment. They should also refrain from making any major decisions until the following day.
On the day of your appointment, we recommend that you:
Wear comfortable clothing
Bring a valid photo ID and insurance card
Avoid alcohol and cannabis use
Eat and hydrate normally unless told otherwise by your provider
During Your First Spravato Appointment
What happens when I arrive at my first Spravato appointment? “Once you arrive at our office, our front desk team will check you in and escort you to your private, quiet treatment room with a comfortable, reclining chair,” says Jessica Sokolovsky, Spravato Administrator at Madison Avenue TMS & Psychiatry. “From there, we will walk through what the session will include and answer any questions you may have.”
How is Spravato administered? Spravato is self-administered, and your clinician will guide you through the administration process. “You will spray one squirt in each nostril,” Sokolovsky says.
Once you have self-administered, you will sit comfortably in a reclining chair for the remaining two hours of your appointment, which will be monitored.
Why is a monitoring period part of Spravato treatment? Spravato is a REMS (Risk Evaluation and Mitigation Strategy)-certified medication, meaning the FDA requires that it be administered in a certified clinic under medical supervision for at least two hours. This ensures that any adverse reactions, such as the potential side effects mentioned below, are addressed on-site during your appointment.
During the two-hour monitoring period, you are welcome to read, listen to music, or simply relax. Your team will monitor your blood pressure, comfort level, and overall response to the medication periodically throughout the visit.
What are the benefits and side effects of Spravato? Patients struggling with treatment-resistant depression who take Spravato may experience a significant reduction of depressive symptoms from their very first appointment. Many patients report:
Noticeable mood improvements during their treatment sessions or within the first few weeks
Relief from depressive symptoms that didn’t respond to other treatments
Greater clarity, energy, and motivation
As with any treatment, there are potential side effects with taking Spravato, such as:
Dizziness or lightheadedness
Temporary dissociation (a floating or “out-of-body” feeling / feeling detached from one’s thoughts, feelings, or surroundings)
Nausea
Increased blood pressure
Perceptual changes, such as distortions of time and space
Visual or auditory hallucinations
While there are common benefits and side effects with Spravato, each person’s experience with the treatment will be unique. “Our staff is here to support you through your Spravato experience and help you feel at ease throughout your appointment,” says Sokolovsky.
After Your First Spravato Appointment: Follow-Up and Treatment Schedule
How often do I have to schedule Spravato treatments? Spravato treatment follows a structured schedule:
Weeks 1–4: Two sessions per week
Weeks 5–8: One session per week
Week 9 and Beyond: Maintenance sessions every 2-4 weeks, based on your progress
How will I know if Spravato is working? As the patient, it is important for you to track your progress, symptoms, and any side effects throughout your Spravato treatment.
“Open communication is key,” Dr. Woo emphasizes. “We always encourage patients to let us know how they’re feeling physically, emotionally, and mentally, both during their sessions and in between appointments. This gives us the opportunity to customize your treatment plan to best fit your needs.”
Take the First Step Toward Relief
Starting a new treatment for depression can feel overwhelming, or it might even feel futile if you haven’t had success with past treatments. But Spravato is specifically meant for treatment-resistant depression and is helping many patients finally find relief after years of struggling. Our team at Madison Avenue TMS & Psychiatry is here to support you through every step of your mental health journey. If you think Spravato may be right for you, call us at (212) 731-2033 or visit madisonavetms.com to schedule a consultation.
If you’re living with major depressive disorder (MDD) and have tried multiple antidepressants without feeling better, you’re not alone. According to recent research, about one-third of patients with major depressive disorder did not respond to two or more oral antidepressants.
Treatment-resistant depression (TRD) is an unfortunate reality for many. You can put in the work — try new medications, deal with the side effects, go to therapy, and follow every step your providers recommend — only to still feel stuck.
But there are promising new treatment options for adults with treatment-resistant depression, including Spravato (esketamine), an FDA-approved breakthrough treatment that’s helping patients find relief, including many here at Madison Avenue TMS & Psychiatry.
What Is Spravato?
Spravato is a prescription nasal spray FDA-approved for adults with treatment-resistant depression and major depressive disorder with suicidal thoughts or behavior. Unlike traditional oral antidepressants, Spravato acts on different receptors in the brain, which affect glutamate, a neurotransmitter associated with mood and cognition.
Unlike standard antidepressants that may take 4–6 weeks to show effects, some patients report improvement within 24 hours of their first dose.
Who Is a Candidate for Spravato?
Spravato is not for everyone and is not a first-line treatment. You may be a candidate if:
You’ve tried two or more oral antidepressants without success
You’ve been diagnosed with treatment-resistant depression
You’re struggling with suicidal thoughts as part of major depressive disorder
Providers consider a variety of factors before recommending Spravato, including:
Medication history and treatment response
Overall mental and physical health
Lifestyle factors, support systems, and treatment goals
Before being prescribed Spravato, patients should complete a thorough psychiatric evaluation to determine the best course of care.
Benefits and Side Effects of Spravato
Patients struggling with treatment-resistant depression who take Spravato may experience a significant reduction of depressive symptoms. Many patients report:
Noticeable mood improvements within the first few weeks
Relief from depressive symptoms that didn’t respond to other treatments
Greater clarity, energy, and motivation
As with any treatment, there are potential side effects, including:
Sleepiness, dizziness, anxiety, or nausea
Temporary dissociation (feeling “out of body”)
Mild sedation or increased blood pressure
Be aware that patients under age 24 have an increased risk of suicidal thoughts and actions when taking any antidepressant, and people with blood vessel disease, a history of aneurysms, or who are allergic to esketamine should not take Spravato
What to Expect from the Spravato Treatment Process
1. Pre-Treatment Consultation
“Your psychiatric team will review your medical history, discuss your symptoms, and determine whether Spravato treatment for depression is right for you,” said Dr. David Woo, head clinical psychiatrist and founder of Madison Avenue TMS & Psychiatry in New York City. “They should handle insurance verification and walk you through the treatment process.”
2. In-clinic Treatment Sessions
Patients self-administer the Spravato nasal spray under the direct observation of licensed clinicians in a comfortable, private suite. Patients can choose to listen to music, read, or simply relax during the duration of the session
Patients will be monitored for at least two hours after administration to ensure their safety and comfort
Patients cannot drive themselves after they take their dose and must arrange transportation; they may use public transit, rideshares, or walk.
3. Spravato Treatment Schedule
The initial phase of Spravato treatment lasts about two months, with the maintenance phase beginning at week 9.
Weeks 1–4: 2 sessions per week
Weeks 5–8: 1 session per week
Week 9 and beyond: Maintenance varies; some patients taper to every other week
Common Questions About Spravato
Below are some common questions about Spravato, but more information can be found on Spravato’s official website.
Is Spravato covered by insurance? Yes, most commercial insurers and Medicare Advantage plans cover Spravato. Our office will help you navigate the insurance process and verify coverage.
Is Spravato approved for children or teens? No. Spravato is approved for adults 18+ only. Our staff can help you explore other options for younger patients.
Where can I get Spravato in NYC? Madison Avenue TMS & Psychiatry is a Risk Evaluation and Mitigation Strategy (REMS) certified provider offering Spravato in Midtown Manhattan.
Why Patients Choose Madison Avenue TMS & Psychiatry for Spravato Treatment
Unlike wellness chains or trendy pop-ups, Madison Avenue TMS & Psychiatryis a psychiatry-led clinic providing science-backed, dual-modality care in NYC for over a decade. As a REMS-certified provider, we offer Spravato treatment in a safe, supportive environment at our location in Midtown Manhattan. Founded by board-certified psychiatrist Dr. David Woo, we specialize in evidence-based, personalized mental health care for treatment-resistant depression.
Board-certified psychiatrist with over a decade of expertise with treatment-resistant depression
Access to both Spravato and TMS therapy, customized to your needs
Evidence-based care in a discreet, quiet, central NYC location
Transparent insurance and billing support, including patient assistance programs
Collaborative treatment plans that prioritize your long-term healing
Specialization in combining TMS + ketamine-based treatments for improved outcomes
Clear communication from the first call to the final session
By listening to each patient’s unique struggles and concerns, Dr. Woo and his care team craft tailored treatment plans that deliver life-changing outcomes.
If You’re Struggling With Treatment-Resistant Depression, Don’t Give Up Hope
We know how exhausting it can be searching for a solution to help your depressive symptoms. But know that relief is possible, and Spravato may be the treatment that changes everything for you.
If you’re ready to explore new options for treatment-resistant depression, we’re here to help. To learn more or schedule a consultation with our team at Madison Avenue TMS & Psychiatry, call us at (212) 731-2033 or visitmadisonavetms.com.
(212) 731-2033